If you are an existing patient needing help, we have a few options for you.
1. Use our patient portal.
2. OR – Call us at 630-371-9980
3. OR – If you are having any difficulty with the phone system, please email at PatientHelp@painchicago.com
4. OR – fill out the following form:
Please complete pain diagram and bring to your appointment. If there are any Demographic/Insurance changes or HIPAA updates, please complete and bring to your appointment. Thank you.
- Patient Demographics
- Signature Sheet
- Pain Diagram
- HIPAA Form
- ARI Form
- Insurance Communications Consent (ICC)
- COVID 19 Consent Form
- Requisition for Forms – FMLA and Other
- Authorization for Release of Medical Records
(Please complete a request for form and fax it to our office at 630-371-1555. There is a 10 business day turnaround time)
- Self Pay Policy Form
- New Patient Packet
- MR Release Form
- Curbside Office Visit Instructions
- Request Medical Records
- Benefits Assignment Policy
- ICC (Portal)
- Interventional Procedure Instructions
This was an answer to prayer. I was at my wits end with pain radiating down both legs, not to mention the terrible pain in my back. I told Dr. Glaser that he had to do something, I can't continue to live with this pain any longer. He suggested the Nervo Spinal cord stimulator. This device has changed my life. I no longer have ANY pain going down my legs and my general pain has been reduced by 70%,as well as my pain meds by 50%. The representatives from Nervo has been very attentive with returning my phone calls and guiding me through the operation. At this point, I give a 5 star review of Pain Specialist of Greater Chicago, Dr John K. Hong, & and all of the Nervo representatives Thank you to everyone for making this happen.
After years of bedside nursing my back was destroyed. I went through all of the steps, therapy, small surgeries, eventually a fusion. I was sent to doctor after doctor. No longer able to walk through an airport, sit at my desk, sleep through the night, carry groceries, walk the dog, bake a cake, I was so sad. I had to give up direct patient care and my life became smaller and smaller. Being very active by nature I felt like my life was pretty much over and would be spending my days reading and watching TV. I developed severe rheumatoid arthritis and my rheumatologist sent me to Dr. Glaser. With their help I can now keep up at work, enjoy my grandson's football games and travel again. I am so grateful. As a nurse I know that pain specialists often get judged because of the drugs they prescribe. This is so sad. That stigma probably prevents many people from getting the care they really need. If you have pain and you can’t live your life anymore, please get help, it is available, it is safe and it can work. Thank you to everyone at the center for giving me my life back, your patience, your dedication.